Ann Green, MPH
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About
Research
Publications
2024
Time spent at health facility is a key driver of patient satisfaction, but did not influence retention to HIV care: A serial cross-sectional study in Mozambique
De Schacht C, Amorim G, Calvo L, Ntasis E, Van Rompaey S, Matsimbe J, Martinho S, Graves E, Alvim M, Green A, Kassim H, Carlos I, Wester C, Audet C. Time spent at health facility is a key driver of patient satisfaction, but did not influence retention to HIV care: A serial cross-sectional study in Mozambique. PLOS ONE 2024, 19: e0299282. PMID: 38635537, PMCID: PMC11025808, DOI: 10.1371/journal.pone.0299282.Peer-Reviewed Original ResearchConceptsHealth facilitiesOdds of viral suppressionPatient satisfactionSatisfaction scoresHIV careHigher oddsViral suppressionAdherence to antiretroviral therapyClient-provider communicationStudy assessed patient satisfactionAssociated with higher oddsReduce patient waiting timesMedian satisfaction scorePatient waiting timesCross-sectional studyGeneralized linear regression modelsOverall satisfaction scoreAssociated with lower retentionAssociated with retentionHealth servicesExit interviewsAssociated with timeClient-providerClinical servicesLinear regression models
2023
Antibiotic prescribing practices for acute respiratory illness in children less than 24 months of age in Kenema, Sierra Leone: is it time to move beyond algorithm driven decision making?
Moon T, Sumah I, Amorim G, Alhasan F, Howard L, Myers H, Green A, Grant D, Schieffelin J, Samuels R. Antibiotic prescribing practices for acute respiratory illness in children less than 24 months of age in Kenema, Sierra Leone: is it time to move beyond algorithm driven decision making? BMC Infectious Diseases 2023, 23: 626. PMID: 37749485, PMCID: PMC10519098, DOI: 10.1186/s12879-023-08606-0.Peer-Reviewed Original ResearchConceptsAcute respiratory illnessMonths of ageAntibiotic prescribing practicesKenema Government HospitalPrescribing practicesRespiratory illnessPediatric acute respiratory illnessPrescribing of antibioticsRespiratory tract infectionsClinical decision support toolCause of mortalityHospital stayRespiratory symptomsStudy nursesTract infectionsClinical courseMedication historyPediatric wardUnnecessary antibioticsProspective studyAntibiotic utilizationResultsA totalAntibiotic useClinical signsChest radiographs
2020
‘I married when I was 16… due to poverty, I had no other way’: multi-level factors influencing HIV-related sexual risk behaviours among adolescent girls in Zambézia, Mozambique
Ridgeway K, Lenzi R, Packer C, González-Calvo L, Moon T, Green A, Burke H. ‘I married when I was 16… due to poverty, I had no other way’: multi-level factors influencing HIV-related sexual risk behaviours among adolescent girls in Zambézia, Mozambique. Culture Health & Sexuality 2020, 23: 414-430. PMID: 32427049, DOI: 10.1080/13691058.2020.1715483.Peer-Reviewed Original ResearchConceptsAdolescent girlsBehavior one yearInterpersonal-level factorsRisk behaviorsGirls ages 13Sexual risk behaviorsSelf-reported sexual riskGirls' behaviorFirst time pointAge 13Sexual risk reductionFamily supportHousehold economic stabilityBehavior changeFuture interventionsMulti-level factorsGirlsSexual riskTime pointsInterventionDepth interviewsAdolescentsBehaviorOne-yearSupportMonitoring Pharmacy and Test Kit Stocks in Rural Mozambique: U.S. President's Emergency Plan for AIDS Relief Surveillance to Help Prevent Ministry of Health Shortages
Bravo M, Peratikos MB, Muicha AS, Mahagaja E, Alvim MFS, Green AF, Wester CW, Vermund SH. Monitoring Pharmacy and Test Kit Stocks in Rural Mozambique: U.S. President's Emergency Plan for AIDS Relief Surveillance to Help Prevent Ministry of Health Shortages. AIDS Research And Human Retroviruses 2020, 36: 415-426. PMID: 31914787, PMCID: PMC7232670, DOI: 10.1089/aid.2019.0057.Peer-Reviewed Original ResearchConceptsRural Zambézia ProvinceHuman immunodeficiency virusPresident's Emergency PlanMedication supplyU.S. President's Emergency PlanTimes higher oddsMedication classesViral suppressionDiagnostic test kitsImmunodeficiency virusPharmacy dataStudy midpointOrdinal logistic regressionHigher oddsCare providersLower oddsZambézia ProvinceTuberculosis testingMonitoring of drugsLogistic regressionAIDS ReliefHealth shortagesARVEmergency plansCalendar timeMultiple Concurrent Illnesses Associated with Anemia in HIV-Infected and HIV-Exposed Uninfected Children Aged 6–59 Months, Hospitalized in Mozambique
Duffy C, Kenga D, Gebretsadik T, Maússe F, Manjate A, Zaqueu E, Fernando H, Green A, Sacarlal J, Moon T. Multiple Concurrent Illnesses Associated with Anemia in HIV-Infected and HIV-Exposed Uninfected Children Aged 6–59 Months, Hospitalized in Mozambique. American Journal Of Tropical Medicine And Hygiene 2020, 102: 605-612. PMID: 31933456, PMCID: PMC7056436, DOI: 10.4269/ajtmh.19-0424.Peer-Reviewed Original ResearchConceptsHospital admissionMultiple concurrent illnessesEtiology of anemiaAcute respiratory illnessFactors of anemiaHistory of feverDiagnosis of bacteremiaDiagnosis of malariaGastroenteritis/diarrheaChildren Aged 6Concurrent illnessHIV-InfectedUninfected childrenAntiretroviral therapyAnemia managementCommon diagnosisRespiratory illnessHospitalized childrenMultiple etiologiesBlood culturesMild anemiaNonphysician cliniciansRelative oddsDual diagnosisHIVHope, Self-Efficacy, and Crushed Dreams: Exploring How Adolescent Girls’ Future Aspirations Relate to Marriage and Childbearing in Rural Mozambique
Packer C, Ridgeway K, Lenzi R, González-Calvo L, Moon T, Green A, Burke H. Hope, Self-Efficacy, and Crushed Dreams: Exploring How Adolescent Girls’ Future Aspirations Relate to Marriage and Childbearing in Rural Mozambique. Journal Of Adolescent Research 2020, 35: 579-604. DOI: 10.1177/0743558419897385.Peer-Reviewed Original ResearchAdolescent girlsIndividual-level protective factorsLongitudinal qualitative designFuture aspirationsBehavioral competenceSustainable economic opportunitiesProtective factorsExternal assetsGirlsIntervention evaluationRural MozambiqueQualitative designAge 18CompetenceChild marriageDevelopment lensEconomic opportunitiesDepth interviewsInterventionEarly marriageGoalMarriageHopeConstructsContraceptive access
2019
Immunodeficiency at Antiretroviral Therapy Start: Five-Year Adult Data (2012–2017) Based on Evolving National Policies in Rural Mozambique
Arinze F, Gong W, Green A, De Schacht C, Carlucci J, Silva W, Claquin G, Tique J, Stefanutto M, Graves E, Van Rompaey S, Alvim M, Tomo S, Moon T, Wester C. Immunodeficiency at Antiretroviral Therapy Start: Five-Year Adult Data (2012–2017) Based on Evolving National Policies in Rural Mozambique. AIDS Research And Human Retroviruses 2019, 36: 39-47. PMID: 31359762, PMCID: PMC9836686, DOI: 10.1089/aid.2019.0043.Peer-Reviewed Original ResearchConceptsCD4 cell countMedian CD4 cell countAntiretroviral therapyART initiationSevere immunodeficiencyCell countMedian changeHealth facilitiesHigher median CD4 cell countsMultivariable logistic regression modelAdvanced HIV diseaseAntiretroviral therapy (ART) startMedian CD4 cellProvider-initiated testingCombination antiretroviral therapyStage 4 diseaseTreatment-naive adultsLogistic regression modelsUniversal HIVOlder patientsCD4 cellsHIV diseaseTherapy startMale sexFemale sexA longitudinal qualitative evaluation of an economic and social empowerment intervention to reduce girls’ vulnerability to HIV in rural Mozambique
Burke H, Packer C, González-Calvo L, Ridgeway K, Lenzi R, Green A, Moon T. A longitudinal qualitative evaluation of an economic and social empowerment intervention to reduce girls’ vulnerability to HIV in rural Mozambique. Evaluation And Program Planning 2019, 77: 101682. PMID: 31369827, DOI: 10.1016/j.evalprogplan.2019.101682.Peer-Reviewed Original ResearchConceptsInequitable gender normsSocial empowerment interventionLongitudinal qualitative evaluationFocus group discussionsGender normsMulti-sector interventionsIntergenerational sexDepth interviewsVulnerable girlsCommunity membersGirls' sexual behaviorRural MozambiqueSexual behaviorGroup discussionsMixed-methods evaluationEmpowerment interventionBusiness trainingSchool attendanceHouseholdsMozambiqueBusinessMoneyRisky sexVulnerabilityIDIHIV Rapid Diagnostic Test Inventories in Zambézia Province, Mozambique: A Tale of 2 Test Kits
Wahlfeld C, Muicha A, Harrison P, Kipp A, Claquin G, Silva W, Green A, Wester C, Moon T. HIV Rapid Diagnostic Test Inventories in Zambézia Province, Mozambique: A Tale of 2 Test Kits. International Journal Of Health Policy And Management 2019, 8: 292-299. PMID: 31204445, PMCID: PMC6571497, DOI: 10.15171/ijhpm.2019.07.Peer-Reviewed Original ResearchConceptsHIV rapid diagnostic testsRapid diagnostic testsHealth facilitiesZambézia ProvinceDiagnostic testsTest kitIdentification of PLHIVHealth facility levelMixed-effects logistic regressionOutcomes of interestSpecific health facilityProvincial health authoritiesHIV testUNAIDS 90Treat programsUni-GoldSpecific healthcare facilitiesHealth authoritiesLogistic regressionSurveillance dataFacility levelStudy periodEssential medicinesConfirmatory testHealthcare facilities
2018
Exploring intersections of localised gender norms and unanticipated effects of a sexual and reproductive health intervention: implications of respect and being a “good girl” in Zambézia Province, Mozambique
Lenzi R, Packer C, Ridgeway K, Moon T, Green A, González-Calvo L, Burke H. Exploring intersections of localised gender norms and unanticipated effects of a sexual and reproductive health intervention: implications of respect and being a “good girl” in Zambézia Province, Mozambique. Culture Health & Sexuality 2018, 21: 575-590. PMID: 30328775, DOI: 10.1080/13691058.2018.1498540.Peer-Reviewed Original ResearchConceptsGender normsGood girlGender-based violenceSocial empowerment interventionHead of householdFocus group discussionsReproductive health programsReproductive health interventionsEmpower girlsUnanticipated effectsEmic definitionDepth interviewsCommunity membersRural communitiesImplications of respectGirls' riskGroup discussionsInfluential menEmpowerment interventionSchool attendanceMozambiqueNormsCommunityProgram evaluationZambézia Province